Medicare Contracting

Does Medicare retro the activation date on contracts or do we have to wait until we get the ok date from Medicare?


Christine M Liles, CPC
Insurance Supervisor
P-865-342-5811
F-865-637-5057

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Serving East Tennessee's Dermatology Needs for 40 Years

Comments

  • Good morning,

    Yes Medicare will retro the start date to the date the physician started seeing patients. We hold our claims until we receive the number and at that point release the claims.

    Thanks

    Jorge R Quintero, MHA, CRCE-P
    Manager, Medical and Financial Management
    Martin Health System
    Office Main: 772-223-5945, ext 14925
    Office Direct: 772-223-4925
    Fax: 772-223-5646
    E-mail: Jorge.quintero@martinhealth.org

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  • Medicare will go back 30 days from the activation date.

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    Maxine Lewis, CMM, CPC, CPC-I, CCS-P, CPMA
    Main: 513-771-7070
    Direct: 513-672-4363
    Fax: 513-326-7640
    200 Northland Blvd
    Cincinnati, OH 45246
    mlewis@scrogginsgrear.com
    www.scrogginsgrear.com

  • edited May 2017
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    For PECOS applications, you provide a start date that is no more than 30
    days from the date of the PECOS entry date.



    So, when hiring new physicians or other credentialed providers, it is best
    to not schedule Medicare patients until all credentialing requirements are
    in and you are ready for the entry process.



    Hold the claims until the approval is complete. It can take Provider
    Enrollment up to 120 days to complete, and sometimes more, depending on the
    volume in their department.



    In essence, it can be up to 150 days before a new provider sees payment from
    Medicare for their patient encounters.



    Karen A. Hurley, BS, CMM, CPC, CNA

    President, HPMSI

    PO Box 409

    Parrish, FL 34219-0409

    Tel: (941) 776-4822

    Fax: (240) 368-0059

    Web: www.hpmsi.com



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